Michael J Decicco MD PLLC

Primary specialty

Otolaryngology PhysicianTaxonomy code 207Y00000X

License

220674 Issued in NY

Legal business name

MICHAEL J DECICCO MD PLLC

Practice address

200 North St
Suite 301
Geneva, NY 14456-1561

Phone

(315) 787-5353

Fax

(315) 315-7875

NPI assigned

Feb 12, 2007

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Michael J Decicco, MD

Title

Owner

Phone

(315) 787-5353

Specialties & licenses 3

Addresses

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1171238400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1187740800000",
    "number": "1417099136",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "67 KENDALL STREET",
            "address_2": "SUITE 200",
            "city": "CLIFTON SPRINGS",
            "state": "NY",
            "postal_code": "14432",
            "telephone_number": "315-462-9482",
            "fax_number": "315-462-5438"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 NORTH ST",
            "address_2": "SUITE 301",
            "city": "GENEVA",
            "state": "NY",
            "postal_code": "144561561",
            "telephone_number": "315-787-5353",
            "fax_number": "315-315-7875"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MICHAEL J DECICCO MD PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-12",
        "last_updated": "2007-08-22",
        "status": "A",
        "authorized_official_last_name": "DECICCO",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "315-787-5353",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207Y00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Otolaryngology",
            "state": "NY",
            "license": "220674",
            "primary": true
        },
        {
            "code": "207YP0228X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Otolaryngology, Pediatric Otolaryngology",
            "state": "NY",
            "license": "220674",
            "primary": false
        },
        {
            "code": "207YS0123X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Otolaryngology, Facial Plastic Surgery",
            "state": "NY",
            "license": "220674",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Leonard G. Meggs, M.D.
• Lisa Marie Meringola, NURSE
• Kimberly Merville
• Victoria Lynn Mesko, FNP
• Pamela J. Metting, AUD
• Michael P. Huson PT, LLC
• Colleen Ann Middlebrook, LPN
• Midlakes Neurology PLLC
• Elizabeth Marie Mikuszewski, PHYSICIAN ASSISTANT
• Karen L. Miller, PT

• Otolaryngology Physician in Geneva, NY
• Providers in Geneva, NY by specialty
• Otolaryngology Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.